261 APPLICATION FOR REGISTRATION OF CORPORATE NAME OR RENEWAL OF NAME REGISTRATION To the Secretary of State of the State of Idaho: Pursuant to Section 30-1-403, Idaho Code, the undersigned corporation hereby applies for the registration of its corporate name and submits the following statement: 1. The name of the corporation: 2. The name in which it shall use in Idaho: 3. It is incorporated under the laws of 4. The date of its incorporation 5. The business in which it is engaged is: 6. This application is accompanied by an original certificate of existence or good standing executed by the official having custody of the records pertaining to corporations in the jurisdiction in which it is incorporated. 7. Check here if a renewal. Dated (Name of Corporation) Signed Typed Name Capacity The fee for a new registration is $5.00 for every month or part thereof remaining in the calendar year. The fee for renewing a registration for one calendar year is $60.00. Filing Office Use Only Submit application and certificate of status to: Idaho Secretary of Stateof State Office of the Secretary 450 N 4th Street 700 W Jefferson PO Box 83720 PO Box 83720 Boise ID 83720-0080 Boise, Idaho 83720-0080 g:\corp\forms\misc forms\name registration.pm6 Revised 09/2002 Note: Web Form American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS Optional: If the document is incorrect where can you be reached for questions? Complete and submit the application in duplicate . An application for name registration of corporate name is for an out of state corporation which does not intend to transact business in Idaho. The corporation only wishes to register the corporate name with this office. 1. Line 1: Enter the name of the corporation as it was filed in the domestic state of incorporation. 2. Line 2: If the corporate name on line 1 of the application does not contain a word distinguishing the company as a corporation you must adopt a name to use in Idaho and indicate such name in line 2. If available, you may be able to use the same corporate name with an ending such as corporation, incorporated, company or limited, or any abbreviation thereof. 3. Line 3: Enter the date of incorporation in the state of its incorporation. This date must be exact and include the day, month & year. 4. Line 4: Enter a brief description of the nature of the business in which the corporation is engaged. 5. The application must be accompanied by a certificate of existence (may also be called a certificate of goodstanding), dated within 90 days from the date of filing with this office. Please note this certificate is a one page document issued from the filing office where the articles of incorporation are filed. This cerfiticate is not a certified copy, nor is it a certificate regarding tax status. 6. Mark the box only if this is a renewal to an existing application for a name registration already on file with this office. All name registrations expire on December 31 each year. 7. The application must be signed by an officer of the corporation. The person signing the document must be identified by typing his/her name below the signature and indicating in what capacity they are signing. 8. Enclose the appropriate fee: a. If this is the first time filing, the fee is $5.00 per month for the remainder of the calendar year. b. If this is a renewal for the following year, and if filed between October 1 and December 31, the fee is $60.00. c. If expedited service is requested, add $20.00 to the filing fee. d. If the fees are to be paid from the filing party’s pre-paid customer account, conspicuously indicate the customer account number in the cover letter or transmittal document. Pursuant to Idaho Code § 67-910(6), the Secretary of State’s Office may delete a business entity filing from our database if payment for the filing is not completed. 9. Mail or deliver to: Office of the Secretary of State Idaho Secretary of State 700 W 4th Street 450 N Jefferson PO Box 83720 PO Box 83720 Boise ID 83720-0080 Boise ID 83720-0080 10. If you have questions or need help, call the Secretary of State’s Office at (208) 334-2301. American LegalNet, Inc. www.FormsWorkflow.com